Ayesha Victoria Neal, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

9386 Issued in NC

Practice address

513 Glen Canyon Dr
Fayetteville, NC 28303-3218

Phone

(910) 447-9555

Fax

(844) 833-5682

NPI assigned

Apr 15, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Ayesha Victoria White Former name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gateway Communications, PLLC

  • Speech-Language Pathologist
  • Fayetteville, NC
  • NPI 1437517935
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1396035952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 GLEN CANYON DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033218",
            "telephone_number": "910-447-9555",
            "fax_number": "844-833-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 GLEN CANYON DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033218",
            "telephone_number": "910-447-9555",
            "fax_number": "844-833-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "AYESHA",
        "middle_name": "VICTORIA",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "9386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AYESHA",
            "last_name": "WHITE",
            "middle_name": "VICTORIA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Speech-Language Pathologist in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.